Sarcopenia Influences Clinical Outcome in Hospitalized Patients with Peripheral Artery Disease Aged 75 Years and Older

Ann Vasc Surg. 2025 Jan;110(Pt B):54-65. doi: 10.1016/j.avsg.2024.09.066. Epub 2024 Oct 19.

Abstract

Background: Sarcopenia represents a relevant comorbidity in patients with peripheral artery disease (PAD). However, only few studies exist assessing the clinical burden of sarcopenia in PAD.

Methods: All hospitalizations of patients aged ≥75 years who were admitted due to PAD within 2005-2020 in Germany were included in the study and stratified for sarcopenia. Temporal trends and the impact of sarcopenia on treatment procedures as well as adverse in-hospital events were investigated.

Results: Overall, 1,166,848 hospitalization cases of patients admitted due to PAD (median age 81.0 [78.0-85.0] years; 49.5% female sex) were included, of which 2,109 (0.2%) were coded with sarcopenia. Prevalence of sarcopenia in these patients increased during the observational period from 0.05% in 2005 to 0.34% in 2020 (β 2.61 [95%CI 2.42-2.80], P < 0.001). Sarcopenic PAD patients were more often female (52.1% vs. 49.5%, P = 0.015), obese (6.6% vs. 5.5%, P = 0.021), and revealed higher prevalences of comorbidities (Charlson comorbidity index, 7.00 [6.00-9.00] vs. 6.00 [5.00-7.00], P < 0.001). Sarcopenia was associated with reduced usage of reperfusion treatments (endovascular intervention: odds ratio (OR) 0.409 [95%CI 0.358-0.466], P < 0.001; surgical revascularization: OR 0.705 [95%CI 0.617-0.805], P < 0.001) but higher conduction of amputation (OR 1.365 [95%CI 1.231-1.514], P < 0.001) and higher rates of major adverse cardiovascular and cerebrovascular events (MACCE) (OR 1.313 [95%CI 1.141-1.512], P < 0.001) and in-hospital death (OR 1.229 [95%CI 1.052-1.436], P = 0.009).

Conclusions: Sarcopenia is an under-recognized condition in PAD patients of high clinical relevance causing a crucial disease burden. Awareness of the ailment needs to be increased in daily clinical practice to identify sarcopenia and improve the clinical outcome of this vulnerable patient group.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Comorbidity*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / mortality
  • Female
  • Germany / epidemiology
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Peripheral Arterial Disease* / diagnosis
  • Peripheral Arterial Disease* / epidemiology
  • Peripheral Arterial Disease* / mortality
  • Peripheral Arterial Disease* / therapy
  • Prevalence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sarcopenia* / diagnosis
  • Sarcopenia* / epidemiology
  • Sarcopenia* / mortality
  • Sarcopenia* / therapy
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects
  • Vascular Surgical Procedures / mortality